Toujeo vs Tresiba? Forced to change by insurance company!

What are your thoughts on Toujeo vs Tresiba. I have been using Tresiba for about 4 years and my A1C never went over a 5.7. My recent A1C was 5.3 on tresiba. I am just concerned that my BS will not be as good on Toujeo. My Dr said if we can show data that BS is worse on Toujeo he can send an appeal. What do you guys think? I hate when an middle man pharmacutical company is making health decisions basely on profit.

I agree with your sentiment. This has been an issue in recent years and even has a name: non-medical prescription switching. This may harm patients simply to enable the pharmacy benefit managers’ (PBM) pursuit of profit. You and your doctor should not have to prove that one medication (Tresiba) is superior to another (Toujeo). The burden of that proof should fall on the PBM instead.

Your blood glucose control is excellent and no-one should mess with your meds. But given that the crass drive toward profit has infected our medical care system, you will need to push back. It sounds like your doctor is up for the task.

If it were me, I would strap on a CGM and conduct one 14-day record with Tresiba and one with Toujeo. I suspect that your results will be better with Tresiba and you could use that data to make your appeal. If they’re not then you can switch to Toujeo with some confidence.

Here’s a resource that may help you mount a successful appeal.

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I love Tresiba and was very unhappy when my insurance wanted to switch me to another insulin. I gave my doctor a list of all the reasons why I needed to stay on Tresiba. I filled the prescription for Basgalar but never used it.

I think my doctor had to talk with the insurance company twice but they finally came around. They have approved Tresiba for a year. Good luck to you. We really can’t let the insurance companies change what keeps us healthy.

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The insurance companies usually just require a “valid” reason for you to use your preferred insulin. One of the reasons accepted by my insurance company was the new one doesn’t work as well. I can’t say I completely blame them considering how the big pharm companies have been raking in money on insulins lately. But they bargain with the insulin companies each year about which one will be the preferred brand. None of us want to switch though from something that is working for us. Not only might it not work as well, you have to figure out what a new insulin will behave like. Not the easiest task all the time. So I don’t like it either, I just get the reason they do it.

This is why a back up of supplies is really helpful. I believe trying it can even be for just a few days before you discover it’s not working as well. I remember years ago when I was asked to switch from humalog, I filled the prescription, literally used the new one for a short duration and told my doctor it didn’t work as well and she submitted the paperwork for it and got it switched back to humalog. The only trick was the next couple of years I had to pay more for the non preferred insulin, until the preferred one became humalog again.

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